[Indications, technic and results following Sedlacek-Kambic-Tucker reconstructive partial resection of the larynx].
Management of laryngeal carcinoma located at the anterior commissure remains controversial. Local control rates with radiotherapy or surgery are not as good as those seen after treatment of midcord lesions. The vertical partial laryngectomy with epiglottic reconstruction (VPLER) may be a more successful approach to such lesions. The charts of all patients treated for larynx carcinoma between 1991 and 1996 at the authors' institutions were reviewed to identify those patients treated with VPLER as described by Sedlacek in 1965, Kambic in 1976 and Tucker in 1979. Indications for performing surgery and outcome data of patients were collected and analyzed according to the indications for surgery, surgical technique, perioperative complications, oncological outcomes and functional results. Twelve patients were identified that had been treated with VPLER. Indications for surgery included five patients with local recurrences following endoscopic laser partial laryngectomies, four cases with previously untreated primary tumors at the anterior commissure (T2 N0-2 M0), two with local recurrences following radiotherapy, and one with recurrence following frontolateral partial laryngectomy. There were no postoperative complications except for one laryngocutaneous fistula that required secondary repair. All patients were able to swallow at the tenth postoperative day. All had their tracheostomies closed after completion of wound healing, (a mean of 17 days after surgery). Phonatory results were usually poor. Two local recurrences occurred during the follow-up period. However, both patients were salvaged with total laryngectomies and have since been free from disease. All other patients are alive and well. Our findings show that VPLER is an effective surgical approach for carcinoma at the anterior commissure of the larynx that cannot be adequately managed with transoral laser surgery or simple frontolateral partial laryngectomy. This study demonstrates that the procedure can be successfully applied to the treatment of local recurrences following initial radiotherapy or surgery. No major complications occurred in our study.
Schröder
U
U
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universität zu Köln.
Eckel
H E
HE
Jungehülsing
M
M
Thumfart
W
W
D000328:Adult; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery*; D004825:Epiglottis / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy; D007828:Laryngoscopy; D007830:Larynx / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome; D014945:Wound Healing
Indikation, Technik und Ergebnisse der rekonstruktiven Kehlkopfteilresektion nach Sedlacek-Kambic-Tucker.